Maribel Rivera
Lorain,OH
Summary
Results driven Medical Biller with over 33 years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Overview
34
34
years of professional experience
Work History
Billing Clerk
Allergy Sinus Center
Lawrenceville, NJ
05.2000 - Current
- Performed filing duties including sorting incoming mail, maintaining filing system, and organizing documents.
- Investigated and responded to customer inquiries related to billing issues.
- Corresponded with customers regarding their accounts, making adjustments when necessary.
- Managed all payments processing, invoicing and collections tasks.
- Generated monthly financial statements for customers.
- Reviewed customer files to make sure all documentation was complete and accurate.
- Analyzed customer account records in order to identify any irregularities or inaccuracies.
- Developed processes to improve efficiency and accuracy of billing process.
- Assisted in the collection of overdue accounts by contacting customers via telephone or mail correspondence.
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
- Collected, posted and managed patient account payments.
- Submitted claims to insurance companies.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Performed insurance verification, pre-certification and pre-authorization.
- Checked claims coding for accuracy with ICD-10 standards.
Patient Account Representative
Capital Health Systems
Trenton, NJ
02.1990 - 03.2023
- Provided customer service to patients regarding billing inquiries and account information.
- Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
- Researched discrepancies in patient accounts to determine appropriate resolution.
- Processed payments from patients and maintained accurate records of all transactions.
- Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
- Updated existing patient files with relevant information such as changes in address or contact information.
- Resolved any issues arising from incorrect or incomplete documentation relating to a particular claim.
- Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.
- Worked closely with insurance companies to obtain authorization for services rendered.
- Submitted appeals on behalf of patients when appropriate based on findings from research conducted into denied claims.
- Submitted electronic bills following facility and legal compliance standards.
- Reconciled payments received against outstanding invoices ensuring proper posting of credits and debits.
- Interacted with other departments within the organization such as finance, accounting, IT, and Human Resources when necessary.
- Processed refunds, disbursements, and payments.
- Stayed current with the latest updates for third party, collection, and bad-debt regulations by reading bulletins and other memoranda. Participated in annual training sessions as required.
- Operated computer software efficiently to complete required billing and follow up tasks
- Reviewed appropriate documents. Elicited information and followed appropriate federal, state, third party and departmental guidelines to prepare bills to carriers.
Education
High School Diploma -
Trenton Central High School
Trenton, NJ06-1987
Skills
- Invoice Processing
- Billing Statement Management
- Account Collections
- Customer Communication
- Payment Processing
- Bookkeeping
- Payment Transactions
- Financial Recordkeeping
- Customer Service
- Account Management
- Account Reconciliation
- Database Updates
Languages
Spanish
Native/ Bilingual
Timeline
Billing Clerk
Allergy Sinus Center
05.2000 - Current
Patient Account Representative
Capital Health Systems
02.1990 - 03.2023
High School Diploma -
Trenton Central High School
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